A Zn-doped etch-and-rinse adhesive may improve the mechanical properties and the integrity at the bonded-dentin interface

Influence of inorganic nanoparticles on dental materials' mechanical properties. A narrative review

Inorganic nanoparticles have been widely incorporated in conventional dental materials to help in improving their properties. The literature has shown that incorporating nanoparticles in dental materials in different specialties could have a positive effect on reinforcing the mechanical properties of those materials; however, there was no consensus on the effectiveness of using nanoparticles in enhancing the mechanical properties of dental materials, due to the variety of the properties of nanoparticles itself and their effect on the mechanical properties. This article attempted to analytically review all the studies that assessed the effect of different types of inorganic nanoparticles on the most commonly used dental materials in dental specialties such as polymethyl methacrylate, glass ionomer cement, resin composite, resin adhesive, orthodontic adhesive, and endodontic sealer. The results had shown that those inorganic nanoparticles demonstrated positive potential in improving those mechanical properties in most of the dental materials studied. That potential was attributed to the ultra-small sizes and unique physical and chemical qualities that those inorganic nanoparticles possess, together with the significant surface area to volume ratio. It was concluded from this comprehensive analysis that while a definitive recommendation cannot be provided due to the variety of nanoparticle types, shapes, and incorporated dental material, the consensus suggests using nanoparticles in low concentrations less than 1% by weight along with a silane coupling agent to minimize agglomeration issues and benefit from their properties.

Nanotechnology for Dentistry: Prospects and Applications

In the XXI century, application of nanostructures in oral medicine has become common. In oral medicine, using nanostructures for the treatment of dental caries constitutes a great challenge. There are extensive studies on the implementation of nanomaterials to dental composites in order to improve their properties, e.g., their adhesive strength. Moreover, nanostructures are helpful in dental implant applications as well as in maxillofacial surgery for accelerated healing, promoting osseointegration, and others. Dental personal care products are an important part of oral medicine where nanomaterials are increasingly used, e.g., toothpaste for hypersensitivity. Nowadays, nanoparticles such as macrocycles are used in different formulations for early cancer diagnosis in the oral area. Cancer of the oral cavity-human squamous carcinoma-is the sixth leading cause of death. Detection in the early stage offers the best chance at total cure. Along with diagnosis, macrocycles are used for photodynamic mechanism-based treatments, which possess many advantages, such as protecting healthy tissues and producing good cosmetic results. Application of nanostructures in medicine carries potential risks, like long-term influence of toxicity on body, which need to be studied further. The introduction and development of nanotechnologies and nanomaterials are no longer part of a hypothetical future, but an increasingly important element of today's medicine.

Dexamethasone-doped nanoparticles improve mineralization, crystallinity and collagen structure of human dentin

OBJECTIVES

Bioactive materials have been used for functionalization of adhesives to promote dentin remineralization. This study aims to evaluate bonding ability and both mechanical and chemical behavior of demineralized dentin infiltrated with polymeric nanoparticles doped with dexamethasone (Dex-NPs).

METHODS

Dentin conditioned surfaces were infiltrated with NPs, Dex-NPs or Dex-Zn-NPs. Bonded interfaces were also created and stored for 24 h or 21d, and then submitted to microtensile bond strength testing. Dentin remineralization was analyzed by Nanohardness, Young's modulus and Raman analysis.

RESULTS

At 21d of storage, dentin treated with undoped-NPs attained the lowest nanohardness and Young's modulus. Dex-NPs and Zn-Dex-NPs increased dentin nanohardness and Young's modulus after 21d Raman analysis showed high remineralization, crystallinity, crosslinking and better structure of collagen when functionalized Dex-NPs were present at the dentin interface.

CONCLUSIONS

Infiltration of dentin with Dex-NPs promoted functional remineralization as proved by nanomechanical and morpho-chemical evaluation tests. Dexamethasone in dentin facilitated crystallographic maturity, crystallinity and improved maturity and secondary structure of dentin collagen.

CLINICAL SIGNIFICANCE

Using dexamethasone-functionalized NPs before resin infiltration is a clear option to obtain dentin remineralization, as these NPs produce the reinforcement of the dentin structure, which will lead to the improvement of the longevity of resin restorations.

The inhibitory effects of various ions released from S-PRG fillers on dentin protease activity

This study investigates the effect of ions released from S-PRG fillers on host-derived enzymatic degradation of dentin collagen matrices. Dentin beams (n=80) were demineralized and distributed to eight groups following baseline dry mass and total MMP activity assessments. Each group treated with boron, fluoride, sodium, silicone, strontium, aluminium, or S-PRG eluate solutions for 5 min. Untreated beams served as control. After pre-treatment, MMP activity was reassessed, beams were incubated in complete medium for 1 week, dry mass was reassessed. Incubation media were analyzed for MMP and cathepsin-K-mediated degradation fragments. Data were analyzed with ANOVA and Tukey's test. All pretreatment groups showed significant reduction in total MMP activity (p<0.05) that was sustainable after incubation in all groups except for boron and silicone groups (p<0.05). Cathepsin-K activity did not differ between control or treatment groups. The results indicated that ions released from S-PRG fillers have the potential to partly inhibit MMP-mediated endogenous enzymatic activity.

Effects of the Combined Application of Trimethylated Chitosan and Carbodiimide on the Biostability and Antibacterial Activity of Dentin Collagen Matrix

The structural integrity of a dentin matrix that has been demineralized by the clinical use of etchants or calcium-depleting endodontic irrigants, such as endodontic ethylenediaminetetraacetic acid (EDTA), is often deteriorated due to the collagenolytic activities of reactivated endogenous enzymes as well as the infiltration of extrinsic bacteria. Therefore, the biomodification of dentin collagen with improved stability and antibacterial activity holds great promise in conservative dentistry. The purpose of this study was to evaluate the effects of the combined application of trimethylated chitosan (TMC) and 1-ethyl-3-[3-dimethylaminopropyl]carbodiimide hydrochloride (EDC) on the biostability and antibacterial activity of the demineralized dentin collagen matrix. The morphological changes in the collagen matrix were observed by scanning electron microscopy (SEM), the amount of TMC adsorbed on the collagen surface was detected by X-ray photoelectron spectroscopy, and the elastic modulus was measured by a three-point bending device. Dry weight loss and amino acid release were detected to evaluate its anti-collagenase degradation performance. The antibacterial performance was detected by confocal microscopy. The TMC-treated group had less collagen space and a more compact collagen arrangement, while the untreated group had a looser collagen arrangement. The combined application of TMC and EDC can increase the elastic modulus, reduce the loss of elastic modulus, and result in good antibacterial performance. The current study proved that a dentin collagen matrix biomodified by TMC and EDC showed improved biodegradation resistance and antibacterial activities.

Zn-containing Adhesives Facilitate Collagen Protection and Remineralization at the Resin-Dentin Interface: A Narrative Review

This is a narrative review of the literature assessing the potential effectiveness of doping dentin polymeric adhesives with zinc compounds in order to improve bonding efficacy, remineralization and protection against degradation. A literature search was conducted using electronic databases, such as PubMed, MEDLINE, DIMDI and Web of Science. Through our search, we found literature demonstrating that Zn-doped dentin adhesives promote protection and remineralization of the resin-dentin interfaces. The increased bioactivity has also facilitated dentinal tubules' occlusion by crystals' precipitation contributing to improved sealing efficacy of restorations. Loading dentin adhesives with zinc gives rise to an increase of both crystallinity of mineral and crosslinking of collagen. The main role of zinc, in dentin adhesives, is to inhibit collagen proteolysis. We concluded that zinc exerts a protective effect through binding at the collagen-sensitive cleavage sites of matrix-metalloproteinases (MMPs), contributing to dentin matrix stabilization. Zinc may not only act as a MMPs inhibitor, but also influence signaling pathways and stimulate metabolic effects in dentin mineralization and remineralization processes. Zn-doped adhesives increase the longevity of dentin bonding through MMPs inhibition. Zn poses a remineralization strategy in demineralized dentin.

An in-vitro study investigating the effect of air-abrasion bioactive glasses on dental adhesion, cytotoxicity and odontogenic gene expression

OBJECTIVE

To assess the microtensile bond strength (MTBS) and interfacial characteristics of universal adhesives applied on dentine air-abraded using different powders. The analysis includes the cytotoxicity of the powders and their effect on odontogenic gene expression.

METHODS

Sound human dentine specimens were air-abraded using bioglass 45S5 (BAG), polycarboxylated zinc-doped bioglass (SEL), alumina (AL) and submitted to SEM analysis. Resin composite was bonded to air-abraded or smear layer-covered dentine (SML) using an experimental (EXP) or a commercial adhesive (ABU) in etch&rinse (ER) or self-etch (SE) modes. Specimens were stored in artificial saliva (AS) and subjected to MTBS testing after 24 h and 10 months. Interfacial nanoleakage assessment was accomplished using confocal microscopy. The cytotoxicity of the powders was assessed, also the total RNA was extracted and the expression of odontogenic genes was evaluated through RT-PCR.

RESULTS

After prolonged AS storage, specimens in the control (SML) and AL groups showed a significant drop in MTBS (p > 0.05), with degradation evident within the bonding interface. Specimens in BAG or SEL air-abraded dentine groups showed no significant difference, with resin-dentine interfaces devoid of important degradation. The metabolic activity of pulp stem cells was not affected by the tested powders. SEL and BAG had no effect on the expression of odontoblast differentiation markers. However, AL particles interfered with the expression of the odontogenic markers.

SIGNIFICANCE

The use of bioactive glass air-abrasion may prevent severe degradation at the resin-dentine interface. Unlike alumina, bioactive glasses do not interfere with the normal metabolic activity of pulp stem cells and their differentiation to odontoblasts.

Synergistic Effect of Bioactive Inorganic Fillers in Enhancing Properties of Dentin Adhesives-A Review

Dentin adhesives (DAs) play a critical role in the clinical success of dental resin composite (DRC) restorations. A strong bond between the adhesive and dentin improves the longevity of the restoration, but it is strongly dependent on the various properties of DAs. The current review was aimed at summarizing the information present in the literature regarding the improvement of the properties of DAs noticed after the addition of bioactive inorganic fillers. From our search, we were able to find evidence of multiple bioactive inorganic fillers (bioactive glass, hydroxyapatite, amorphous calcium phosphate, graphene oxide, calcium chloride, zinc chloride, silica, and niobium pentoxide) in the literature that have been used to improve the different properties of DAs. These improvements can be seen in the form of improved hardness, higher modulus of elasticity, enhanced bond, flexural, and ultimate tensile strength, improved fracture toughness, reduced nanoleakage, remineralization of the adhesive-dentin interface, improved resin tag formation, greater radiopacity, antibacterial effect, and improved DC (observed for some fillers). Most of the studies dealing with the subject area are in vitro. Future in situ and in vivo studies are recommended to positively attest to the results of laboratory findings.

Review of nano-technology applications in resin-based restorative materials

OBJECTIVE

Nanotechnology has progressed significantly and particles as small as 3 nm are being employed in resin-based restorative materials to improve clinical performance. The goal of this review is to report the progress of nanotechnology in Restorative Dentistry by reviewing the advantages, limitations, and applications of resin-based restorative materials with nanoparticles.

MATERIALS AND METHODS

A literature review was conducted using PubMed/Medline, Scopus and Embase databases. In vitro, in vivo and in situ research studies published in English between 1999 and 2020, and which focused on the analysis of resin-based restorative materials containing nanoparticles were included.

RESULTS

A total of 140 studies were included in this review. Studies reported the effect of incorporating different types of nanoparticles on adhesive systems or resin composites. Mechanical, physical, and anti-bacterial properties were described. The clinical performance of resin-based restorative materials with nanoparticles was also reported.

CONCLUSIONS

The high surface area of nanoparticles exponentially increases the bioactivity of materials using bioactive nanofillers. However, the tendency of nanoparticles to agglomerate, the chemical instability of the developed materials and the decline of rheological properties when high ratios of nanoparticles are employed are some of the obstacles to overcome in the near future.

CLINICAL SIGNIFICANCE

In spite of the recent advancements of nanotechnology in resin-based restorative materials, some challenges need to be overcome before new nano-based restorative materials are considered permanent solutions to clinical problems.

Zn-doping of silicate and hydroxyapatite-based cements: Dentin mechanobiology and bioactivity

The objective was to state zinc contribution in the effectiveness of novel zinc-doped dentin cements to achieve dentin remineralization, throughout a literature or narrative exploratory review. Literature search was conducted using electronic databases, such as PubMed, MEDLINE, DIMDI, Embase, Scopus and Web of Science. Both zinc-doping silicate and hydroxyapatite-based cements provoked an increase of both bioactivity and intrafibrillar mineralization of dentin. Zinc-doped hydroxyapatite-based cements (oxipatite) also induced an increase in values of dentin nano-hardness, Young's modulus and dentin resistance to deformation. From Raman analyses, it was stated higher intensity of phosphate peaks and crystallinity as markers of dentin calcification, in the presence of zinc. Zinc-based salt formations produced low microleakage and permeability values with hermetically sealed tubules at radicular dentin. Dentin treated with oxipatite attained preferred crystal grain orientation with polycrystalline lattices. Thereby, oxipatite mechanically reinforced dentin structure, by remineralization. Dentin treated with oxipatite produced immature crystallites formations, accounting for high hydroxyapatite solubility, instability and enhanced remineralizing activity.

Effect of Methacryloyloxydecyl Dihydrogen Phosphate–Containing Silane and Adhesive Used Alone or in Combination on the Bond Strength and Chemical Interaction With Zirconia Ceramics Under Thermal Aging

Clinical Relevance

Achieving durable bonding to zirconia is fundamental for the application of a methacryloyloxydecyl dihydrogen phosphate (MDP)–containing silane solution or an MDP-containing silane solution associated with an MDP-containing universal adhesive.

SUMMARY

Objectives: To evaluate the effect of a methacryloyloxydecyl dihydrogen phosphate (MDP)–containing silane coupling agent and universal adhesive, used alone or in combination, on the microshear bond strength (μSBS) to zirconia after 24 hours of water storage (24h) and after 10,000 thermocycles (TC), complemented with chemical analysis of the surface to establish the presence of MDP on the surface of the zirconia after bonding procedures.

Methods and Materials: Thirty computer-aided design/computed-aided manufacturing blocks of zirconia were cut into four sections (6×6×6 mm) and sintered. Zirconia sections (n=96) were assigned to 24 groups according to three factors: 1) silane (no silane, Monobond S [MBS], Monobond P [MB+]), 2) adhesive + resin cement (no adhesive + Enforce [ENF], no adhesive + RelyX Ultimate [REX], Prime&Bond Elect + Enforce [PBE/ENF], Scotchbond Universal + RelyX Ultimate [SBU/REX]), and 3) thermocycling (no thermocycling [24h], 10,000 thermocycles [TC]). Upon silane/adhesive application, cylinder-shaped matrices were filled with resin cement and light cured. Specimens were tested in μSBS (1.0 mm/min) after 24h or TC. The μSBS data were analyzed using twoway ANOVA and Tukey’s post hoc test (α=0.05). In addition, micro-Raman spectroscopy was used to analyze the zirconia surface for immediate chemical interaction analysis (n=24).

Results: For the 24h condition, PBE/ENF resulted in lower mean μSBS than both groups with silane without PBE (MBS and MB+ groups; p&lt;0.001). SBU alone or MB+ alone and MB+ associated with SBU showed the highest mean μSBS (p&lt;0.001). For the TC condition, all groups showed a significant decrease in mean μSBS compared with those of 24h (p&lt;0.001), with the exception of MB+ associated to SBU (p&gt;0.05). However, the application of MB+ alone or MB+ associated to SBU resulted in higher mean μSBS (p&lt;0.001) after TC than the remaining TC groups. In terms of chemical interaction, only the SBU groups, alone or combined with both of the silane agents, were associated with the methacrylate groups after rinsing.

Conclusions: The results of the current study support the use of an MDP-containing silane solution or an MDP-containing silane solution associated with an MDP-containing universal adhesive for bonding to air-abraded zirconia, as a more stable bonding after thermocycling.

Effect of Remineralized Collagen on Dentin Bond Strength through Calcium Phosphate Ion Clusters or Metastable Calcium Phosphate Solution

This study aimed to investigate whether dentin remineralization and micro-tensile bond strength increase when using calcium phosphate ion clusters (CPICs) or metastable Ca-P. After being etched, each dentin specimen was designated into four groups and treated with the appropriate solution for 1 min: 100% ethanol, 2 and 1 mg/mL of CPICs, and metastable Ca-P. The specimens were then prepared for scanning electron microscopy (SEM), transmission electron microscropy (TEM) imaging, a matrix metalloproteinases inhibition assay, and the micro-tensile bond strength test. To compare among the groups, one-way analysis of variance was performed. In the SEM imaging, with a rising concentration of CPICs, the degree of remineralization of dentin increased significantly. The metastable Ca-P treated specimens showed a similar level of remineralization as the 1 mg/mL CPICs treated specimens. The TEM imaging also revealed that dentin remineralization occurs in a CPICs concentration-dependent manner between the demineralized dentin and the resin layer. Furthermore, the results of micro-tensile bond strength showed the same trend as the results confirmed by SEM and TEM. We demonstrated that a 1 min pretreatment of CPICs or metastable Ca-P in etched dentin collagen fibril can achieve biomimetic remineralization and increase micro-tensile bond strength.

Advances of Anti-Caries Nanomaterials

Caries is the most common and extensive oral chronic disease. Due to the lack of anti-caries properties, traditional caries filling materials can easily cause secondary caries and lead to treatment failure. Nanomaterials can interfere with the bacteria metabolism, inhibit the formation of biofilm, reduce demineralization, and promote remineralization, which is expected to be an effective strategy for caries management. The nanotechnology in anti-caries materials, especially nano-adhesive and nano-composite resin, has developed fast in recent years. In this review, the antibacterial nanomaterials, remineralization nanomaterials, and nano-drug delivery systems are reviewed. We are aimed to provide a theoretical basis for the future development of anti-caries nanomaterials.

Effects of Zn-Doped Mesoporous Bioactive Glass Nanoparticles in Etch-and-Rinse Adhesive on the Microtensile Bond Strength

The purpose of this study was to assess the effects in the dentin bond strength of dental adhesives (DAs) and biological effects using zinc (Zn)-doped mesoporous bioactive glass nanoparticles (MBN-Zn). Synthesized MBN and MBN-Zn were characterized by scanning electron microscopy (SEM), X-ray diffraction and the Brunauer, Emmett and Teller (BET) method. The matrix metalloproteinases (MMP) inhibition effects of DA-MBN and DA-MBN-Zn were analyzed. The microtensile bond strength (MTBS) test was conducted before and after thermocycling to investigate the effects of MBN and MBN-Zn on the MTBS of DAs. The biological properties of DA-MBN and DA-MBN-Zn were analyzed with human dental pulp stem cells (hDPSCs). Compared with the DA, only the DA-1.0% MBN and DA-1.0% MBN-Zn exhibited a statistically significant decrease in MMP activity. The MTBS values after thermocycling were significantly increased in DA-1.0% MBN and DA-1.0% MBN-Zn compared with the DA (p < 0.05). It was confirmed via the MTT assay that there was no cytotoxicity for hDPSCs at 50% extract. In addition, significant increases in the alkaline phosphatase activity and Alizarin Red S staining were observed only in DA-1.0%MBN-Zn. These data suggest the 1.0% MBN and 1.0% MBN-Zn enhance the remineralization capability of DAs and stabilize the long-term MTBS of DAs by inhibiting MMPs.

Zinc oxide and copper nanoparticles addition in universal adhesive systems improve interface stability on caries-affected dentin

This study evaluated the MMP inhibition of the zinc oxide and copper nanoparticles (ZnO/CuNp), and the effects of their addition into adhesives on antimicrobial activity (AMA), ultimate tensile strength (UTS), in vitro degree of conversion (in vitro-DC), as well as, resin-dentin bond strength (μTBS), nanoleakage (NL) and in situ-DC on caries-affected dentin. Anti-MMP activity was evaluated for several MMPs. ZnO/CuNp (0% [control]; 5/0.1 and 5/0.2 wt%) were added into Prime&Bond Active (PBA) and Ambar Universal (AMB). The AMA was evaluated against Streptococcus mutans. UTS were tested after 24 h and 28d. After induced caries, adhesives and composite were applied to flat dentin surfaces, and specimens were sectioned to obtain resin-dentin sticks. μTBS, NL, in vitro-DC and in situ-DC were evaluated after 24 h. ANOVA and Tukey's test were applied (α = 0.05). ZnO/CuNp demonstrated anti-MMP activity (p < 0.05). The addition of ZnO/CuNp increased AMA and UTS (AMB; p < 0.05). UTS for PBA, in vitro-DC, in situ-DC and μTBS for both adhesives were maintained with ZnO/CuNp (p > 0.05). However, lower NL was observed for ZnO/CuNp groups (p < 0.05). The addition of ZnO/CuNp in adhesives may be an alternative to provide antimicrobial, anti-MMP activities and improves the integrity of the hybrid layer on caries-affected dentin.

Novel dental composite with capability to suppress cariogenic species and promote non-cariogenic species in oral biofilms

Recurrent caries often occurs and is a primary reason for the failure of dental composite restorations. The objectives of this study were to: (1) develop a bioactive composite containing dimethylaminohexadecyl methacrylate (DMAHDM), (2) investigate its antibacterial effects and suppression on biofilm growth, and (3) investigate its ability to modulate biofilm species composition for the first time. DMAHDM was incorporated into a composite at mass% of 0%, 0.75%, 1.5%, 2.25% and 3%. A commercial composite Heliomolar served as a comparative control. A biofilm model consisting of Streptococcus mutans (S. mutans), Streptococcus sanguinis (S. sanguinis) and Streptococcus gordonii (S. gordonii) was tested by growing biofilms for 48 h and 72 h on composites. Colony-forming units (CFUs), metabolic activity and live/dead staining were evaluated. Lactic acid and polysaccharide productions were measured to assess biofilm cariogenicity. TaqMan real-time polymerase chain reaction was used to determine the proportion of each species in the biofilm. DMAHDM-containing composite had a strong anti-biofilm function, reducing biofilm CFU by 2-3 orders of magnitude, compared to control composite. Biofilm metabolic activity, lactic acid and polysaccharides were decreased substantially, compared to control (p < 0.05). At 72 h, the cariogenic S. mutans proportion in the biofilm on the composite with 3% DMAHDM was 19.9%. In contrast, an overwhelming S. mutans proportion of 92.2% and 91.2% existed in biofilms on commercial control and 0% DMAHDM, respectively. In conclusion, incorporating DMAHDM into dental composite: (1) yielded potent anti-biofilm properties; (2) modulated the biofilm species composition toward a non-cariogenic tendency. The new DMAHDM composite is promising for applications in a wide range of tooth cavity restorations to modulate oral biofilm species and combat caries.

Stored potential energy increases and elastic properties alterations are produced after restoring dentin with Zn-containing amalgams

The aim of this research was to ascertain the mechanical and chemical behavior of sound and caries-affected dentin (CAD), after the placement of Zn-free vs containing amalgam restorations. Peritubular and intertubular dentin were evaluated using, a) nanoindenter in scanning mode; the load and displacement responses were used to perform the nano-Dynamic mechanical analysis and to estimate the complex (E * ) and storage modulus (E'); b) Raman spectroscopy was used to describe the hierarchical cluster analysis (HCA). Assessments were performed before restoration placement and after restoring, and after 3 months of storage with thermocycling (100,000cy/5 °C and 55 °C). When CAD was treated with Zn-containing restorations, differences between E * and E' at both peritubular and intertubular dentin augmented, with energy concentration and production of implications in the mechanical performance of the restored teeth. E * and E' were very low at intratubular dentin of CAD restored with Zn-containing restorations. The relative presence of minerals, the phosphate crystallinity and the crosslinking of collagen increased their values at both types of dentin (peritubular and intertubular) when CAD was treated with Zn-containing restorations. The nature and secondary structure of collagen improved in CAD treated with Zn-containing amalgams. Different levels of dentin remineralization were revealed by hierarchical cluster analysis.

Zn-containing polymer nanogels promote cervical dentin remineralization

OBJECTIVE

Nanogels designing for effective treatment of eroded cervical dentin lesions.

MATERIALS AND METHODS

Polymethylmetacrylate-based nanoparticles (NPs) were doxycycline (D), calcium, or zinc loaded. They were applied on eroded cervical dentin. Treated surfaces were characterized morphologically by atomic force and scanning electron microscopy, mechanically probed by a nanoindenter to test nanohardness and Young's modulus, and chemically analyzed by Raman spectroscopy at 24 h and 7 days of storage. Data were submitted to ANOVA and Student-Newman-Keuls multiple comparisons tests.

RESULTS

Dentin treated with Zn-NPs attained the highest nanomechanical properties, mineralization, and crystallinity among groups. Nanoroughness was lower in Zn-treated surfaces in comparison to dentin treated with undoped gels. Dentin treated with Ca-NPs created the minimal calcification at the surface and showed the lowest Young's modulus at peritubular dentin. Intertubular dentin appeared remineralized. Dentinal tubules were empty in samples treated with D-NPs, partially occluded in cervical dentin treated with undoped NPs and Ca-NPs, and mineral covered when specimens were treated with Zn-NPs.

CONCLUSIONS

Zn-loaded NPs permit functional remineralization of eroded cervical dentin. Based on the tested nanomechanical and chemical properties, Zn-based nanogels are suitable for dentin remineralization.

CLINICAL RELEVANCE

The ability of zinc-loaded nanogels to promote dentin mineralization may offer new strategies for regeneration of eroded cervical dentin and effective treatment of dentin hypersensitivity.

In vitro mechanical stimulation facilitates stress dissipation and sealing ability at the conventional glass ionomer cement-dentin interface

OBJECTIVE

The aim of this study was to evaluate the induced changes in the chemical and mechanical performance at the glass-ionomer cement-dentin interface after mechanical load application.

METHODS

A conventional glass-ionomer cement (GIC) (Ketac Bond), and a resin-modified glass-ionomer cement (RMGIC) (Vitrebond Plus) were used. Bonded interfaces were stored in simulated body fluid, and then tested or submitted to the mechanical loading challenge. Different loading waveforms were applied: No cycling, 24 h cycled in sine or loaded in sustained hold waveforms. The cement-dentin interface was evaluated using a nano-dynamic mechanical analysis, estimating the complex modulus and tan δ. Atomic Force Microscopy (AFM) imaging, Raman analysis and dye assisted confocal microscopy evaluation (CLSM) were also performed.

RESULTS

The complex modulus was lower and tan delta was higher at interfaces promoted with the GIC if compared to the RMGIC unloaded. The conventional GIC attained evident reduction of nanoleakage. Mechanical loading favored remineralization and promoted higher complex modulus and lower tan delta values at interfaces with RMGIC, where porosity, micropermeability and nanoleakage were more abundant.

CONCLUSIONS

Mechanical stimuli diminished the resistance to deformation and increased the stored energy at the GIC-dentin interface. The conventional GIC induced less porosity and nanoleakage than RMGIC. The RMGIC increased nanoleakage at the porous interface, and dye sorption appeared within the cement. Both cements created amorphous and crystalline apatites at the interface depending on the type of mechanical loading.

CLINICAL SIGNIFICANCE

Remineralization, lower stress concentration and resistance to deformation after mechanical loading improved the sealing of the GIC-dentin interface. In vitro oral function will favor high levels of accumulated energy and permits micropermeability at the RMGIC-dentin interface which will become remineralized.

ZnCl2 Incorporated into Experimental Adhesives: Selected Physicochemical Properties and Resin-Dentin Bonding Stability

The aim of this study was to evaluate the degree of conversion (DC%), water sorption (WS), solubility (SO), and resin-dentin bonding stability of experimental adhesive systems containing ZnCl₂. Different concentrations (wt.%) of ZnCl₂ were added to a model etch-and-rinse adhesive system consisting of BISGMA, HEMA, UDMA, GDMA, water, and ethanol: Zn0 (0%-control group); Zn2 (2%); Zn3.5 (3.5%); and Zn5 (5%). Adper Single Bond 2 (SB) was used as commercial reference. The samples were light cured for 20s using a quartz-tungsten-halogen unit (650 mW/cm²). DC% (n = 5) was measured using FT-IR spectroscopy, and WS and SO (n = 5) were calculated based on ISO4049. Microtensile bond strength (μTBS) and nanoleakage (NL) were measured after 24 h and 12 months of water storage (n = 10). Data were analyzed using ANOVA and Tukey's HSD test (5%). Zn5 presented the lowest DC% and the highest WS and SO (p < 0.05). Zn0 and Zn2 presented statistically similar DC%, WS, SO, and immediate μTBS. All adhesives containing ZnCl₂ maintained a μTBS stability after 12 months, but only Zn2 and Zn3.5 did not suffer an increase in NL. SB presented the highest immediate μTBS but the greatest reduction after 12 months (p < 0.05). The addition of 2 wt.% of ZnCl₂ in adhesive formulations seems to be a promising way to improve the resin-dentin bonding stability. Higher concentrations than 2 wt.% could impair some physicochemical properties.

A zinc chloride-doped adhesive facilitates sealing at the dentin interface: A confocal laser microscopy study

The aim of this study was to ascertain the effect of Zn-doping of dental adhesives and mechanical load cycling on the micromorphology of the resin-dentin interdiffusion zone (of sound and caries affected dentin). The investigation considered two different Zn-doped adhesive approaches and evaluated the interface using a doubled dye fluorescent technique and a calcium chelator fluorophore under a confocal laser scanning microscopy. Sound and carious dentin-resin interfaces of unloaded specimens were deficiently resin-hybridized, in general. These samples showed a rhodamine B-labeled hybrid layer and adhesive layer completely affected by fluorescein penetration (nanoleakage) through the porous resin-dentin interface. It was thicker after phosphoric acid-etching and more extended in carious dentin. Zn-doping promoted an improved sealing of the resin-dentin interface, a decrease of the hybrid layer porosity, and an increment of dentin mineralization. Load cycling augmented the sealing of the Zn-doped resin-dentin interfaces, as porosity and nanoleakage diminished, and even disappeared in caries-affected dentin substrata conditioned with EDTA. Sound and carious dentin specimens analyzed with the xylenol orange technique produced a clearly outlined fluorescence when resins were Zn-doped, due to a consistent Ca-mineral deposition within the bonding interface and inside the dentinal tubules. It was more evident when load cycling was applied on specimens treated with self-etching adhesives that were Zn-doped. Micropermeability at the resin-dentin interface diminished after combining EDTA pretreatment, ZnCl₂-doping and mechanical loading stimuli on restorations. It is clearly preferable to include the zinc compounds into the bonding constituents of the self-etching adhesives, instead of into the primer ingredients. The promoted new mineral segments contributed to reduce or avoid both porosity and nanoleakage from the load cycled Zn-doped resin dentin interfaces. EDTA+SB-ZnCl₂ or SEB·Bd-Zn doping are preferred to treat caries-affected dentin surfaces. ZnO-doping encouraged for etch-and-rinse adhesives.

Mechanical loading influences the viscoelastic performance of the resin-carious dentin complex

The aim of this study was to evaluate the changes in the mechanical behavior and bonding capability of Zn-doped resin-infiltrated caries-affected dentin interfaces. Dentin surfaces were treated with 37% phosphoric acid (PA) followed by application of a dentin adhesive, single bond (SB) (PA+SB) or by 0.5 M ethylenediaminetetraacetic acid (EDTA) followed by SB (EDTA+SB). ZnO microparticles of 10 wt. % or 2 wt. % ZnCl₂ was added into SB, resulting in the following groups: PA+SB, PA+SB-ZnO, PA+SB-ZnCl₂, EDTA+SB, EDTA+SB-ZnO, EDTA+SB-ZnCl₂. Bonded interfaces were stored for 24 h, and tested or submitted to mechanical loading. Microtensile bond strength was assessed. Debonded surfaces were evaluated by scanning electron microscopy and elemental analysis. The hybrid layer, bottom of the hybrid layer, and peritubular and intertubular dentin were evaluated using a nanoindenter. The load/displacement responses were used for the nanodynamic mechanical analysis III to estimate complex modulus, tan delta, loss modulus, and storage modulus. The modulus mapping was obtained by imposing a quasistatic force setpoint to which a sinusoidal force was superimposed. Atomic force microscopy imaging was performed. Load cycling decreased the tan delta at the PA+SB-ZnCl₂ and EDTA+SB-ZnO interfaces. Tan delta was also diminished at peritubular dentin when PA+SB-ZnO was used, hindering the dissipation of energy throughout these structures. Tan delta increased at the interface after using EDTA+SB-ZnCl₂, lowering the energy for recoil or failure. After load cycling, loss moduli at the interface decreased when using ZnCl₂ as doping agent, increasing the risk of fracture; but when using ZnO, loss moduli was dissimilarly affected if dentin was EDTA-treated. The border between intertubular and peritubular dentin attained the highest discrepancy in values of viscoelastic properties, meaning a risk for cracking and breakdown of the resin-dentin interface. PA used on dentin provoked differences in complex and storage modulus values at the intertubular and peritubular structures, and these differences were higher than when EDTA was employed. In these cases, the long-term performance of the restorative interface will be impaired.

[Progress on matrix metalloproteinase inhibitors]

Continuing advances in dentin bonding technology and adhesives revolutionized bonding of resin-based composite restorations. However, hybrid layers created by contemporary dentin adhesives present imperfect durability, and degradation of collagen matrix by endogenous enzymes is a significant factor causing destruction of hybrid layers. Bond durability can be improved by using enzyme inhibitors to prevent collagen degradation and to preserve integrity of collagen matrix. This review summarizes progress on matrix metalloproteinase inhibitors (including chlorhexidine, ethylenediaminetetraacetic acid, quaternary ammonium salt, tetracycline and its derivatives, hydroxamic acid inhibitors, bisphosphonate derivative, and cross-linking agents) and suggests prospects for these compounds.

The innovative applications of therapeutic nanostructures in dentistry

Nanotechnology has paved multiple ways in preventing, reversing or restoring dental caries which is one of the major health care problems. Nanotechnology aided in processing variety of nanomaterials with innovative dental applications. Some showed antimicrobial effect helping in the preventive stage. Others have remineralizing potential intercepting early lesion progression as nanosized calcium phosphate, carbonate hydroxyapatite nanocrystals, nanoamorphous calcium phosphate and nanoparticulate bioactive glass particularly with provision of self-assembles protein that furnish essential role in biomimetic repair. The unique size of nanomaterials makes them fascinating carriers for dental products. Thus, it is recentlyclaimedthat fortifying the adhesives with nanomaterials that possess biological meritsdoes not only enhance the mechanical and physical properties of the adhesives, but also help to attain and maintain a durable adhesive joint and enhanced longevity. Accordingly, this review will focus on the current status and the future implications of nanotechnology in preventive and adhesive dentistry.

Oral Function Improves Interfacial Integrity and Sealing Ability Between Conventional Glass Ionomer Cements and Dentin

The aim of this study was to investigate if load cycling affects interfacial integrity of glass ionomer cements bonded to sound- or caries-affected dentin. A conventional glass ionomer, Ketac Bond, and a resin-modified glass ionomer (Vitrebond Plus), were applied to dentin. Half of the specimens were load cycled. The interfaces were submitted to dye-assisted confocal microscopy evaluation. The unloaded specimens of sound and carious dentin were deficiently hybridized when Ketac Bond was used. Ketac Bond samples showed an absorption layer and an adhesive layer that were scarcely affected by fluorescein penetration (nanoleakage), in sound dentin. Nevertheless, a higher degree of micropermeability was found in carious dentin. In Ketac Bond specimens, load cycling improves the sealing capability and remineralization at the cement-dentin interface as porosity and nanoleakage was reduced. In contrast, samples treated with Vitrebond Plus exhibited a Rhodamine B-labeled absorption layer with scarce nanoleakage in both sound and carious unloaded dentin. The adhesive layer was affected by dye sorption throughout the porous cement-dentin interface. Samples treated with Vitrebond Plus had significant increases in nanoleakage and cement-dye sorption after load cycling. Within the limitations of an in vitro study, it is expected that conventional glass ionomers will provide major clinical efficacy when applied to carious-affected or sound dentin.

Determining Optimal Fluorescent Agent Concentrations in Dental Adhesive Resins for Imaging the Tooth/Restoration Interface

Fluorescent dyes like Rhodamine B (RB) have been used to identify the spatial distribution of adhesive restorative materials in the tooth/restoration interface. Potential effects of the addition of RB to dental adhesives were addressed in the past, but no further information is available on how to determine suitable concentrations of RB in these bonding agents for imaging in the confocal laser scanning microscope. This study provides systematical strategies for adding RB to viscous dental adhesive resins, focusing on the determination of the lowest range of dye concentrations necessary to achieve an acceptable image of the dentin/adhesive interface. It was demonstrated that optimized images of the resin distribution in dentin can be produced with 0.1-0.02 mg/mL of RB in the (tested) adhesives. Our approaches took into account aspects related to the dye concentration, photophysical parameters in different host media, specimen composition and morphology to develop a rational use of the fluorescent agent with the resin-based materials. Information gained from this work can help optimize labeling methods using dispersions of low-molecular-weight dyes in different monomer blend systems.

Promotive Effect of Zinc Ions on the Vitality, Migration, and Osteogenic Differentiation of Human Dental Pulp Cells

Zinc is an essential trace element for proper cellular function and bone formation. However, its exact role in the osteogenic differentiation of human dental pulp cells (hDPCs) has not been fully clarified before. Here, we speculated that zinc may be effective to regulate their growth and osteogenic differentiation properties. To test this hypothesis, different concentrations (1 × 10^-5, 4 × 10^-5, and 8 × 10^-5 M) of zinc ions (Zn²⁺) were added to the basic growth culture medium and osteogenic inductive medium. Cell viability and migration were measured by cell counting kit-8 (CCK-8) and transwell migration assay in the basic growth culture medium, respectively. The reverse transcription-quantitative polymerase chain reaction (RT-qPCR) was used to detect the gene expression levels of selective osteogenic differentiation markers and zinc transporters. Alkaline phosphatase (ALP) activity analysis and alizarin red S staining were used to investigate the mineralization of hDPCs. Exposure of hDPCs to Zn²⁺ stimulated their viability and migration capacity in a dose- and time-dependent manner. RT-qPCR assay revealed elevated expression levels of osteogenic differentiation-related genes and zinc transporters genes in various degrees. ALP activity was also increased with elevated Zn²⁺ concentrations and extended culture periods, but enhanced matrix nodules formation were observed only in 4 × 10^-5 and 8 × 10^-5 M Zn²⁺ groups. These findings suggest that specific concentrations of Zn²⁺ could potentiate the vitality, migration, and osteogenic differentiation of hDPCs. We may combine optimum zinc element into pulp capping materials to improve their biological performance.

Water interaction and bond strength to dentin of dye-labelled adhesive as a function of the addition of rhodamine B

Objective

This study investigated the effect of the fluorescent dye rhodamine B (RB) for interfacial micromorphology analysis of dental composite restorations on water sorption/solubility (WS/WSL) and microtensile bond strength to dentin (µTBS) of a 3-step total etch and a 2-step self-etch adhesive system.

Material and Methods

The adhesives Adper Scotchbond Multi-Purpose (MP) and Clearfil SE Bond (SE) were mixed with 0.1 mg/mL of RB. For the WS/WSL tests, cured resin disks (5.0 mm in diameter x 0.8 mm thick) were prepared and assigned into four groups (n=10): MP, MP-RB, SE, and SE-RB. For µTBS assessment, extracted human third molars (n=40) had the flat occlusal dentin prepared and assigned into the same experimental groups (n=10). After the bonding and restoration procedures, specimens were sectioned in rectangular beams, stored in water and tested after seven days or after 12 months. The failure mode of fractured specimens was qualitatively evaluated under optical microscope (x40). Data from WS/WSL and µTBS were assessed by one-way and three-way ANOVA, respectively, and Tukey’s test (α=5%).

Results

RB increased the WSL of MP and SE. On the other hand, WS of both MP and SE was not affected by the addition of RB. No significance in µTBS between MP and MP-RB for seven days or one year was observed, whereas for SE a decrease in the µTBS means occurred in both storage times.

Conclusions

RB should be incorporated into non-simplified DBSs with caution, as it can interfere with their physical-mechanical properties, leading to a possible misinterpretation of bonded interface.

Zinc-Containing Restorations Create Amorphous Biogenic Apatite at the Carious Dentin Interface: A X-Ray Diffraction (XRD) Crystal Lattice Analysis

The aim of this research was to assess the ability of amalgam restorations to induce amorphous mineral precipitation at the caries-affected dentin substrate. Sound and caries-affected dentin surfaces were subjected to both Zn-free and Zn-containing dental amalgam restorations. Specimens were submitted to thermocycling (100,000 cycles/5°C-55°C, 3 months). Dentin surfaces were studied by atomic force microscopy (nanoroughness), X-ray diffraction, field emission scanning electron microscopy, and energy-dispersive analysis, for physical and morphological surface characterization. Zn-containing amalgam placement reduced crystallinity, crystallite size, and grain size of calcium phosphate crystallites at the dentin surface. Both microstrain and nanoroughness were augmented in caries-affected dentin restored with Zn-containing amalgams. Caries-affected dentin showed the shortest mineral crystallites (11.04 nm), when Zn-containing amalgams were used for restorations, probably leading to a decrease of mechanical properties which might favor crack propagation and deformation. Sound dentin restored with Zn-free amalgams exhibited a substantial increase in length of grain particles (12.44 nm) embedded into dentin crystallites. Zn-containing amalgam placement creates dentin mineralization and the resultant mineral was amorphous in nature. Amorphous calcium phosphate provides a local ion-rich environment, which is considered favorable for in situ generation of prenucleation clusters, promotong further dentin remineralization.

Zinc-modified nanopolymers improve the quality of resin-dentin bonded interfaces

INTRODUCTION

Demineralized collagen fibers at the hybrid layer are susceptible to degradation. Remineralization may aid to improve bond longevity.

OBJECTIVES

The aim of the present study was to infiltrate zinc and calcium-loaded polymeric nanoparticles into demineralized dentin to facilitate hybrid layer remineralization.

MATERIALS AND METHODS

Zinc or calcium-loaded polymeric nanoparticles were infiltrated into etched dentin, and Single Bond Adhesive was applied. Bond strength was tested after 24 h and 6 months storage. Nanomechanical properties, dye-assisted confocal laser microscopy, and Masson's trichrome staining evaluation were performed to assess for the hybrid layer morphology, permeability, and remineralization ability after 24 h and 3 months. Data were analyzed by ANOVA and Student-Newman-Keuls multiple comparisons tests (p < 0.05).

RESULTS

Immediate bond strength was not affected by nanoparticles infiltration (25 to 30 MPa), while after 6 months, bond strengths were maintained (22 to 24 MPa). After 3 months, permeability occurred only in specimens in which nanoparticles were not infiltrated. Dentin remineralization, at the bottom of the hybrid layer, was observed in all groups. After microscopy analysis, zinc-loaded nanoparticles were shown to facilitate calcium deposition throughout the entire hybrid layer. Young's modulus at the hybrid layer increased from 2.09 to 3.25 GPa after 3 months, in specimens with zinc nanoparticles; meanwhile, these values were reduced from 1.66 to 0.49 GPa, in the control group.

CONCLUSION

Infiltration of polymeric nanoparticles into demineralized dentin increased long-term bond strengths. Zinc-loaded nanoparticles facilitate dentin remineralization within the complete resin-dentin interface.

CLINICAL RELEVANCE

Resin-dentin bond longevity and dentin remineralization at the hybrid layer were facilitated by zinc-loaded nanoparticles.

Improved Sealing and Remineralization at the Resin-Dentin Interface After Phosphoric Acid Etching and Load Cycling

The purpose of this study was to investigate micro-morphology of the resin-dentin inter-diffusion zone using two different single-bottle self-etching dentin adhesives with and without previous acid-etching, after in vitro mechanical loading stimuli. Extracted human third molars were sectioned to obtain dentin surfaces. Two different single-bottle self-etching dentin adhesives, Futurabond U and Experimental both from VOCO, were applied following the manufacturer's instructions or after 37% phosphoric acid application. Resin-dentin interfaces were analyzed with dye assisted confocal microscopy evaluation (CLSM), including the calcium-chelation technique, xylenol orange (CLSM-XO). CLSM revealed that resin-dentin interfaces of unloaded specimens were deficiently resin-hybridized, in general. These samples showed a Rhodamine B-labeled hybrid complex and adhesive layer completely affected by fluorescein penetration (nanoleakage) through the porous resin-dentin interface, but thicker after PA-etching. Load cycling promoted an improved sealing of the resin-dentin interface at dentin, a decrease of the hybrid complex porosity, and an increment of dentin mineralization. Load cycled specimens treated with the XO technique produced a clearly outlined fluorescence due to consistent Ca-mineral deposits within the bonding interface and inside the dentinal tubules, especially when the experimental adhesive was applied.

Advances in Dental Materials through Nanotechnology: Facts, Perspectives and Toxicological Aspects

Nanotechnology is currently driving the dental materials industry to substantial growth, thus reflecting on improvements in materials available for oral prevention and treatment. The present review discusses new developments in nanotechnology applied to dentistry, focusing on the use of nanomaterials for improving the quality of oral care, the perspectives of research in this arena, and discussions on safety concerns regarding the use of dental nanomaterials. Details are provided on the cutting-edge properties (morphological, antibacterial, mechanical, fluorescence, antitumoral, and remineralization and regeneration potential) of polymeric, metallic and inorganic nano-based materials, as well as their use as nanocluster fillers, in nanocomposites, mouthwashes, medicines, and biomimetic dental materials. Nanotoxicological aspects, clinical applications, and perspectives for these nanomaterials are also discussed.

Nanoscopic dynamic mechanical analysis of resin-infiltrated dentine, under in vitro chewing and bruxism events

The aim of this study was to evaluate the induced changes in mechanical behavior and bonding capability of resin-infiltrated dentine interfaces, after application of mechanical stimuli. Dentine surfaces were subjected to partial demineralization through 37% phosphoric acid etching followed by the application of an etch-and-rinse dentine adhesive, Single Bond (3M/ESPE). Bonded interfaces were stored in simulated body fluid during 24h, and then tested or submitted to the mechanical loading challenge. Different loading waveforms were applied: No cycling (I), 24h cycled in sine (II) or square (III) waves, sustained loading held for 24h (IV) or sustained loading held for 72h (V). Microtensile bond strength (MTBS) was assessed for the different groups. Debonded dentine surfaces were studied by field emission scanning electron microscopy (FESEM). At the resin-dentine interface, both the hybrid layer (HL) and the bottom of the hybrid layer (BHL), and both peritubular and intertubular were evaluated using a nanoindenter in scanning mode. The load and displacement responses were used to perform the nano-Dynamic Mechanical analysis and to estimate the complex and storage modulus. Dye assisted Confocal Microscopy Evaluation was used to assess sealing ability. Load cycling increased the percentage of adhesive failures in all groups. Specimens load cycled in held 24h attained the highest complex and storage moduli at HL and BHL. The storage modulus was maximum in specimens load cycled in held 24h at peritubular dentine, and the lowest values were attained at intertubular dentine. The storage modulus increased in all mechanical tests, at peritubular dentine. An absence of micropermeability and nanoleakage after loading in sine and square waveforms were encountered. Porosity of the resin-dentine interface was observed when specimens were load cycled in held 72h. Areas of combined sealing and permeability were discovered at the interface of specimens load cycled in held 24h. Crack-bridging images appeared in samples load cycled with sine waveform, after FESEM examination.

Role of Host-Derived Proteinases in Dentine Caries and Erosion

Demineralization in dentinal caries and erosion exposes dentine organic matrix. This exposed matrix, containing type I collagen and non-collagenous proteins, is then degraded by host collagenolytic enzymes, matrix metalloproteinases (MMPs) and cysteine cathepsins. The knowledge of the identities and function of these enzymes in dentine has accumulated only within the last 15 years, but has already formed a field of research called ‘dentine degradomics'. This research has demonstrated the role of endogenous collagenolytic enzymes in caries and erosion development. In demineralized dentine, the enzymes degrade triple-helical collagen molecules, leading to the gradual loss of collagen matrix. Even before that, they can cleave off the terminal non-helical ends of collagen molecules called telopeptides, leading to the structural changes at the intramolecular gap areas, which may affect or even prevent intrafibrillar remineralization, which is considered essential in restoring the dentine's mechanical properties. They may also cause the loss of non-collagenous proteins that could serve as nucleation sites for remineralization. Here we review the findings demonstrating that inhibition of salivary or dentine endogenous MMPs and cysteine cathepsins may provide preventive means against the progression of caries or erosion. Furthermore, we also suggest the future directions for the new experimental preventive research to gain more knowledge of the enzymes and their function during and after dentine demineralization, and the pathways to find the clinically acceptable means to prevent the functional activity of these enzymes.

Bond strength and bioactivity of Zn-doped dental adhesives promoted by load cycling

The purpose of this study was to evaluate if mechanical loading influences bioactivity and bond strength at the resin-dentin interface after bonding with Zn-doped etch-and-rinse adhesives. Dentin surfaces were subjected to demineralization by 37% phosphoric acid (PA) or 0.5 M ethylenediaminetetraacetic acid (EDTA). Single bond (SB) adhesive—3M ESPE—SB+ZnO particles 20 wt% and SB+ZnCl2 2 wt% were applied on treated dentin to create the groups PA+SB, SB+ZnO, SB+ZnCl2, EDTA+SB, EDTA+ZnO, and EDTA+ZnCl2. Bonded interfaces were stored in simulated body fluid for 24 h and tested or submitted to mechanical loading. Microtensile bond strength (MTBS) was assessed. Debonded dentin surfaces were studied by high-resolution scanning electron microscopy. Remineralization of the bonded interfaces was assessed by atomic force microscope imaging/nanoindentation, Raman spectroscopy/cluster analysis, and Masson's trichrome staining. Load cycling (LC) produced reduction in MTBS in all PA+SB, and no change was encountered in EDTA+SB specimens, regardless of zinc doping. LC increased the mineralization and crystallographic maturity at the interface; a higher effect was noticed when using ZnO. Trichrome staining reflected a narrow demineralized dentin matrix after loading of dentin surfaces that were treated with SB-doped adhesives. This correlates with an increase in mineral platforms or plate-like multilayered crystals in PA or EDTA-treated dentin surfaces, respectively.

Dentin bonding: can we make it last?

In dentin bonding, contemporary dental adhesive systems rely on formation of the hybrid layer, a biocomposite containing dentin collagen and polymerized resin adhesive. They are usually able to create at least reasonable integrity of the hybrid layer with high immediate bond strength. However, loss of dentin-bonded interface integrity and bond strength is commonly seen after aging both in vitro and in vivo. This is due to endogenous collagenolytic enzymes, matrix metalloproteinases, and cysteine cathepsins, responsible for the time-dependent loss of hybrid layer collagen. In addition, the hydrophilic nature of adhesive systems creates problems that lead to suboptimal hybrid layers. These problems include, for example, insufficient resin impregnation of dentin, phase separation, and a low rate of polymerization, all of which may reduce the longevity of the bonded interface. Preservation of the collagen matrix integrity by inhibition of endogenous dentin proteases is key to improving dentin bonding durability. Several approaches to retain the integrity of the hybrid layer and to improve the long-term dentin bond strength have been tested. These include the use of enzyme inhibitors, either separately or as incorporated into the adhesive resins; increase of collagen resistance to enzymatic degradation; and elimination of water from the interface to slow down or eliminate hydrolytic loss of the hybrid layer components. This review looks at the principles, current status, and future of the different techniques designed to prevent the loss of hybrid layer and bond strength.